Health insurance deficit
How Lauterbach wants to plug the billion hole
09/23/2022, 1:57 p.m
The health insurance companies are expected to lose 17 billion euros this year. Health Minister Lauterbach presented his idea in the Bundestag of how this financial gap should be closed. Insured persons must be prepared for a higher contribution.
Federal Minister of Health Karl Lauterbach has defended plans to compensate for a billion-dollar gap in statutory health insurance in the coming year. The vast majority will not be paid for by increasing the contribution rate on the employee side, said the SPD politician when introducing a draft law in the Bundestag.
The expected increase of 0.3 percentage points is reasonable and not unfair. “In contrast to taxes, every employer pays half.” The minister reiterated that health care financial reserves should be addressed first without cutting insured benefits.
The financial package decided by the cabinet is intended to absorb an expected minus of 17 billion euros. Specifically planned are:
- Higher additional contribution: Part of the deficit is to be compensated for by raising the additional contribution for individual health insurers. Lauterbach expects this to increase by an average of 0.3 percentage points. Half of this has to be paid by the insured and the other half by the employer. However, the average additional contribution is only an arithmetical figure based on the estimated financial requirements of the health insurance funds. Each individual fund decides for itself whether and to what extent it increases the additional contribution.
- More money from the federal government: The federal subsidy of currently 14.5 billion euros will be increased by two billion euros in the coming year. The federal government is also granting the GKV an interest-free loan of one billion euros to the health fund for 2023.
- Own contributions of the cash registers: The health insurance companies must also make a solidarity contribution of four billion euros from their reserves. In addition, funds from the health fund amounting to 2.4 billion euros will be used.
- Relief for drug prices: The manufacturer discount that the pharmaceutical companies have to grant the statutory funds for patent-protected drugs will be increased from seven to twelve percent for one year. The pharmacy discount of EUR 1.77 per drug pack will be increased to EUR 2 for two years. This gives health insurers a higher discount for prescription drugs. The moratorium on drug price increases will be extended until the end of 2026. “In the event of unauthorized attacks, we will withstand lobby pressure,” Lauterbach assured in the debate on this point.
- Restrictions on the remuneration of doctors: The additional remuneration that doctors receive for new patients will be abolished. So far, they have received allocations outside of their budget. The growth in fees for dentists will also be limited.
The principle that there should be no cuts in benefits will not be shaken during the entire legislative period. With a view to “efficiency reserves”, Lauterbach explained that funds with many reserves had massively increased pension provisions for board members. There are also cash registers “where the board members earn significantly more than the Federal Chancellor”. Double billing of care services in clinics should be eliminated.
The Bavarian Health Minister Klaus Holetschek sharply criticized the plans and spoke of a “destabilization law”. If the contributions increase, it is not a good signal for people. Skimming off the health insurance companies is the wrong way. “You are heading for a supply blackout,” said the CSU politician to Lauterbach. Abolishing the budget for new patients in practices is a reduction in benefits. “You can sugarcoat that however you want.”
Instead of the planned increase in contributions, a higher federal subsidy is required, said Holetschek. The additional federal subsidy of two billion is far too small. In this context, Holetschek accused Lauterbach of not having asserted itself enough. “The truth is that health policy is made either by the Minister of Justice or the Minister of Finance,” said Holetschek, also with a view to the new Infection Protection Act, in which Federal Justice Minister Marco Buschmann had a significant influence.
It is also the wrong way to skim off the reserves of the health insurance companies. They are no longer even willing to finance Lauterbach’s health kiosk project. “That must make you think,” Holetschek said to Lauterbach.
The social association VdK also opposed the planned increase in contributions. “It would be a particularly fatal signal at this point in time,” said association president Verena Bentele. “Especially people with low incomes suffer very badly from the high inflation and the ever increasing energy prices.”